A Physical Therapist Who Swears: A Case Series

Abstract

Objective: Swearing deserves attention in the physical therapy setting due to its potential positive psychological, physiological, and social effects. The purpose of this case series is to describe 2 cases in which a physical therapist swears in the clinical setting and its effect on therapeutic alliance. Patients: Case 1 is a 19-year-old male treated for a hamstring strain, and case 2 is a 23-year-old male treated post-operatively for anterior cruciate ligament reconstruction. The physical therapist utilized social swearing in the clinic with the goal of motivating the patient and enhancing the social connection with the patient, to improve therapeutic alliance. Results: The patient in case 1 reported a decrease in therapeutic alliance after the physical therapist began swearing during physical therapy treatments, whereas the patient in case 2 reported an increase in therapeutic alliance. Both patients disagreed that physical therapist swearing is unprofessional and disagreed that swearing is offensive, and both patients agreed physical therapists should be able to swear around their patients. Conclusion: Physical therapist swearing may have positive and negative influences in the clinic setting and may not be considered unprofessional. These are, to our knowledge, the first published cases of a physical therapist swearing in the clinical setting. LAY ABSTRACT Swearing produces positive effects that cannot be achieved with any other forms of language. Quite simply, swearing is powerful and deserves attention in the physical therapy setting. Swearing can lead to tighter human bonds, thereby enhancing the social connection between a patient and a physical therapist. This case series describes 2 cases where a physical therapist swears with patients in the clinical setting and its effect on their social connection. While swearing increased the social connection in 1 case, it decreased it in the other case. None of the patients thought that physical therapist swearing was unprofessional, and both patients believe physical therapists should be able to swear around their patients. The results of these cases indicate that physical therapist swearing can have positive and negative influences in the clinic. More studies are needed to help determine when, how, and if to swear in the physical therapy setting.

Keywords

• physical therapy
• swearing
• therapeutic alliance
• professionalism
• communication